Vesicoureteral Reflux Surgery in Children: Expert Treatment in Delhi

Vesicoureteric reflux (VUR) is a condition where urine flows backward from the bladder into the ureters and sometimes up to the kidneys. Normally, urine flows in a one-way direction from the kidneys to the bladder. In children with VUR, the valve mechanism at the junction of the ureter and bladder fails to function properly, allowing reverse flow, which can lead to kidney infections and potential damage over time.

This condition is most often diagnosed in infants and young children, and may affect one (unilateral reflux) or both ureters (bilateral reflux). In Delhi, pediatric urology centers offer comprehensive care, including vesicoureteral reflux surgery in child in Delhi, when necessary.

Types of Vesicoureteric Reflux:

VUR is Categorized into Two Main Types:

1. Primary Vesicoureteric Reflux:

This is a congenital condition caused by improper development of the valve between the ureter and bladder. It is the most common form in children and often improves with age as the urinary tract matures.

2. Secondary Vesicoureteric Reflux:

This form occurs due to underlying problems such as:

• Posterior Urethral Valves (obstruction in boys)

• Neurogenic Bladder (caused by nerve dysfunction)

• Bladder Outlet Obstruction, which leads to urine retention and backward pressure

Symptoms of Vesicoureteric Reflux in Children:

Children with VUR May Present With:

• Recurrent urinary tract infections (UTIs)

• Pain or burning during urination

• Bedwetting (enuresis)

• Frequent urination

• Cloudy or foul-smelling urine

• Fever (especially with infections)

• Abdominal or flank pain

• Poor appetite or irritability

• Hypertension or protein in the urine (in advanced cases)

Diagnosis of Vesicoureteric Reflux:

Early Diagnosis Helps Prevent Kidney Damage. Common Tests Used Include:

• Urinalysis: Detects UTIs and other infections

• Ultrasound of Kidneys and Bladder: Shows structural changes or hydronephrosis

• Micturating Cystourethrogram (MCUG): A dye is introduced into the bladder to track urine flow during urination using X-rays

• Nuclear Scan (DMSA scan): Assesses kidney function and checks for scars from past infections

Grading of Vesicoureteric Reflux:

VUR is classified from Grade I to Grade V, based on how far the urine refluxes:

• Grade I-II: Mild reflux, often resolves with age and conservative management

• Grade III: Moderate reflux, may need close monitoring or treatment

• Grade IV-V: Severe reflux, often requiring surgical intervention

Treatment Options for Vesicoureteric Reflux in Delhi:

1. Medical Management:

• Antibiotic Prophylaxis: Low-dose antibiotics help prevent infections while monitoring for spontaneous resolution

• Bladder Training and Hygiene: Includes timed voiding, preventing constipation, and encouraging fluid intake

• Monitoring: Regular follow-up with imaging and urine tests

2. Vesicoureteral Reflux Surgery Child in Delhi:

When conservative management fails, surgery is recommended—especially in Grades IV and V or in case of recurrent UTIs and kidney damage.

Surgical Options:

• Endoscopic Injection: A bulking agent is injected at the ureteral opening to strengthen the valve. It’s minimally invasive and done under general anesthesia.

• Ureteric Reimplantation: The ureters are repositioned in the bladder to create a new valve mechanism. It has a high success rate (97-99%).

• Laparoscopic or Robotic Surgery: Offers quicker recovery, minimal scars, and shorter hospital stays. These are increasingly preferred in top pediatric centers in Delhi.

Prevention and Care:

Although vesicoureteric reflux cannot always be prevented, the following steps reduce risk and complications:

• Ensure regular urination and avoid holding urine

• Maintain perineal hygiene (especially in girls)

• Encourage a high-fiber diet to prevent constipation

• Treat urinary and fecal incontinence early

• Avoid unnecessary catheter use

Prognosis:

The outlook for children with VUR is positive. Many outgrow the condition with age. For those requiring surgery, vesicoureteral reflux surgery in child in Delhi has excellent outcomes when performed by pediatric urologists. With early diagnosis and proper care, long-term kidney health can be preserved.

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